The Hay Fever Handbook

Hay fever sufferers don’t have to be shut-ins – one must simply learn when it is best to go out.

• Stay inside when pollen levels are at their highest, generally between 5 a.m. and 10 a.m., when the morning dew is drying.
• Check local pollen forecasts before heading out, and ask a doctor for advice on when to take medications.
• Cool and damp conditions are good times to venture out – there will be less pollen in the air. If it is warming up after a rain, change plans. The pollen will become airborne as the water evaporates.
• Get someone else to mow the lawn if you are grass- or mold-allergic (the mower stirs up mold in the grass) and keep the lawn to two inches or less to prevent flowering. Don’t go outside if you hear the neighbor mowing during grass pollen season (May to July).
• Wear a face mask, hat, glasses, gloves and a long-sleeved shirt when working outside. This will keep pollen exposure to a minimum.
• Help yourself by making your garden as allergen-free as possible (and encourage neighbours to do the same). Spring-flowering trees such as cherry and apple are good choices as well as red maple, dogwood and magnolia; they rely on insects to pollinate. (See ‘Sneeze-Free Garden’.)

Relief in a Pill or Spray

After taking necessary avoidance measures, you will probably still need medication to help you get through the season. There are two types of over-the-counter drugs you can turn to: antihistamines and decongestants. Histamines in the body cause sneezing and itchy eyes. What antihistamines do is “block the histamine molecule from working, which reduces symptoms,” says Dr. Harold Kim.

It is recommended that you take antihistamines throughout the allergy season to stop symptoms before they arise. However, Kim does not advise taking antihistamines such as Benadryl on a daily basis because they are sedating.

For continuing daytime use, he prefers the newer, non-sedating, over-the-counter antihistamines (there are several brands). One treatment he favors is such an antihistamine used in tandem with a prescription nasal-steroid spray. Not all these antihistamines are suitable for young children, so consult your doctor before giving them to children with allergies.

Decongestants relieve the swelling associated with a stuffy nose by narrowing the blood vessels, which prevents blood from collecting in the nose. Decongestants are available over-the-counter in oral tablets, liquids, eye drops and nasal sprays. They may not be appropriate for the elderly or for cardiac patients, and Kim cautions that these sprays should not be used longer than three consecutive days to avoid dependence.

Nasal-spray decongestants should not be confused with nasal-steroid sprays such as Nasacort AQ, Flonase or Nasonex, which are applied in a similar fashion, but are suitable for long-term use in treating allergic rhinitis.

When Kim suggests a decongestant to his patients, he generally recommends a combination antihistamine/decongestant. For asthma patients whose allergic symptoms are worse in the spring or fall, Kim suggests speaking to your doctor about increasing your steroid inhaler dosage or switching to an inhaled dose that’s a combination long-acting bronchodilator and steroid.

But even if your hay fever has been bad, it can be controlled and you can have a pleasurable spring. Kim notes that “the vast majority” of those with seasonal rhinitis “can have normal lives, generally by avoiding the outdoor allergens as much as possible and taking their medications.”